Mohs surgery information
STEP 1 & 2 The Mohs surgeon removes a small piece of tissue just around the visible tumor on the skin surface. The tissue is immediately examined with a microscope to identify any cancerous roots that extend beyond the visible boundaries of the tumor.
STEP 3 If any remaining cells from the tissue sample are identified by microscope, their location will be mapped out with the aid of the microscope. Our example above reveals no tumor extending to the periphery of three of the mapped sections, however the exam identifies residual tumor at approximately the 5 o’clock position.
STEP 4 The Mohs surgeon will then return to the area of the remaining tumor cells as indicated by the map and remove another thin layer of tissue just from the specific section where cancer cells were detected.
STEP 5 The process continues until no further cancerous cells are identified. By taking the tissue in thin layers and examining each with
the microscope, the Mohs technique ensures that all the cancerous tissue is removed and prevents the unnecessary removal of healthy tissue.
What First? Know the Facts!
Skin Cancer May Be Worse Than Meets the Eye
Not all treatments for skin cancer are equal. Some of the most common treatments for skin cancer preferred by many physicians are scraping and burning, freezing, radiation and routine excision. While these remedies may be fine for many cancers, you should understand the advantages of Mohs Micrographic Surgery, a process that will remove all of the
cancer, minimize the risk of recurrence, and leave as little scarring as possible.
Mohs Micrographic Surgery is an advanced technique for treating skin cancer and is best performed by a highly trained and experienced surgeon. You can be assured that members of the American College of Mohs Surgery have this training and experience.
When considering your options, or to understand why a skin cancer has recurred, it is important to recognize that a skin that is visible to you - or even to your physician - may just be the tip of the iceberg. You should understand that:
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Not all cancer cells are apparent to the naked eye
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MANY “invisible” cells may form roots or “fingers” of diseased tissue that can extend beyond the boundaries of visible cancer.
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If all the cancer cells are not completely removed, the cancer will re-grow, making it necessary to have it removed again
The Types of Cancer Most Likely to Warrant Mohs Micrographic Surgery:
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Are located in cosmetically sensitive or functionally critical areas around
the eyes, nose, lips, scalp, fingers, toes or genitals. -
Are large, aggressive, or growing rapidly.
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Are recurrent.
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Have ill-defined edges.
For these cancers, common treatment methods are often not successful because they rely on the human eye to determine the extent of the cancer. These methods may remove too little cancer, which can cause it to recur and require additional surgery. It can also result in the removal of too much healthy tissue and may cause unnecessary scarring.
If a cancer has been treated by one of these common methods and it recurs, the chances of it being cured when treated again by one of these same methods becomes even less likely. The scar tissue surrounding a recurrent cancer may hide cancer cells, further complicating the decision of how much tissue to remove.
What Next? Put Your Mind at Ease
Mohs Micrographic Surgery Is Advanced Treatment that Leaves Healthy Tissue Intact
Mohs Micrographic Surgery is a state-of-the-art treatment for skin cancer in which the physician serves as surgeon, pathologist, and reconstructive surgeon.
It relies on the accuracy of a map of the diseased tissue area and the precision of a microscope to trace out and ensure complete removal of the skin cancer—down to its roots. Immediate onsite microscopic examination of the tumor allows ACMS fellowship-trained surgeons to see beyond what is visible to the eye and precisely identify the diseased tissue and remove only the diseased tissue. (See the inset opposite this page.)
ACMS fellowship-trained surgeons have extensive training in reconstructive surgery and are generally able to perform the reconstructive surgery immediately after microscopic analysis confirms that the cancer is completely removed. Most ACMS surgeons are dermatologists whose thorough knowledge of the skin and its healing properties help produce the best cosmetic result possible.
What Can You Expect from Mohs Surgery?
Quick Resolution, Rapid Recovery - Peace of Mind
Mohs Micrographic Surgery is usually performed on an outpatient basis, in one day, under local anesthesia. The healing process is similar to that of most surgical procedures. Of all treatments for skin cancer, Mohs Micrographic Surgery offers the highest cure rate (up to 99% for basal and squamous cell carcinomas) with minimal discomfort and the greatest preservation of normal tissue, thereby minimizing scarring.